祛瘀消肿方外敷配合手法整复夹板外固定治疗老年桡骨远端C型骨折的临床研究  

Clinical Study on Treatment of Elderly Patients with Type C Distal Radius Fracture by External Application of Quyu Xiaozhong Decoction Combined with Manual Reduction and Splint External Fixation

作　　者：周承亮 张伟刚[1] 蒋铭[1] 陆云[1] 张强[1] ZHOU Chengliang;ZHANG Weigang;JIANG Ming;LU Yun;ZHANG Qiang(Min's Traumatology Department,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,China)

机构地区：[1]昆山市中医医院闵氏伤科,江苏昆山215300

出　　处：《中国医学创新》2025年第10期92-97,共6页Medical Innovation of China

基　　金：苏州市卫生青年骨干人才“全国导师制”培训项目(Qngg2022052);昆山市重点研发计划项目(社会发展)(KS2226);昆山市中医院医学新技术项目(KZY2023-053-01)。

摘　　要：目的:回顾性分析祛瘀消肿方外敷配合手法整复夹板外固定治疗老年桡骨远端C型骨折的临床效果。方法:选取2022年1月—2023年1月昆山市中医医院就诊的120例老年桡骨远端C型骨折患者,按照AO分类法中C1、C2、C3型分为A组、B组、C组。三组均接受昆山中医院闵氏伤科正骨手法整复后夹板外固定,同时配合祛瘀消肿方外敷,统计分析三组患者的视觉模拟评分法(VAS)评分、掌倾角、尺偏角及桡骨高度。末次随访采用腕关节Gartland-Werley评分进行腕关节功能评价,观察并统计患者治疗期间出现的并发症。结果:手法整复后即刻、治疗2周、1个月、3个月复查三组掌倾角、尺偏角及桡骨高度均比治疗前改善;其中整复后三组即刻复查影像学指标差异均无统计学意义(P>0.05);三组患者治疗前VAS评分差异有统计学意义(P<0.05),但三组经治疗第3、7、14天的VAS评分差异均无统计学意义(P>0.05);治疗3个月A组影像学指标明显优于B组、C组,差异均有统计学意义(P<0.05);末次随访Gartland-Werley腕关节功能评分,A组临床疗效优良率为86.84%,高于B组的69.05%及C组的62.50%,差异均有统计学意义(P<0.05)。结论:祛瘀消肿方配合手法整复夹板外固定治疗老年桡骨远端C型骨折对患者早期复位后疼痛具有一定的治疗效果;该法对于桡骨远端骨折C1型患者,腕关节功能恢复优良率达86.84%,对于C2、C3型骨折也可获得较好的效果,可以作为不耐受手术或功能要求不是很高的老年患者的一种选择。Objective:To retrospectively analyze the clinical efficacy of external application of Quyu Xiaozhong Decoction combined with manual reconstruction splint external fixation in the treatment of senile distal radius type C fracture.Method:A total of 120 senile distal radius type C fracture patients in Kunshan Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected,and were divided into group A,group B and group C according to AO classification of type C1,C2 and C3.The three groups were all treated with manual reconstruction splint external fixation by Min's Traumatology Department of Kunshan Hospital of Traditional Chinese Medicine,and were treated with external application of Quyu Xiaozhong Decoction.The visual analogue scale(VAS)score,palm inclination angle,ulnar inclination angle,and radial height of the three groups were statistically analyzed.Wrist function was evaluated by Gartland-Werley wrist score at the last follow-up,and the complications during the treatment were observed and counted.Result:Immediately after manual reduction,and during the re-examinations at 2 weeks,1 month,and 3 months of treatment,the palmar inclination angles,ulnar deviation angles,and radial heights of the three groups all improved compared with those before treatment;among them,there were no statistically significant differences in the imaging indexes of the three groups during the immediate after manual reduction(P>0.05).There was a statistically significant difference in VAS score among the three groups before treatment(P<0.05),but there were no statistically significant differences in VAS scores on the 3rd,7th and 14th day of treatment(P>0.05).The imaging indexes of group A were significantly better than those of group B and group C three months of treatment,the differences were statistically significant(P<0.05).The Gartland-Werley score of wrist joint function in the last follow-up showed that the excellent and good rate of clinical efficacy in group A was 86.84%,which was higher than 69.05%in gr

关 键 词：闵氏伤科手法 夹板外固定 祛瘀消肿方 老年桡骨远端C型骨折 

分 类 号：R274.1[医药卫生—中医骨伤科学]